Non-contrast-enhanced magnetic resonance angiography for detecting crossing renal vessels in infants and young children: comparison with contrast-enhanced angiography and surgical findings
Knowing that ureteropelvic junction obstruction is due to a crossing renal vessel is essential in choosing the appropriate surgical treatment.
To evaluate the diagnostic accuracy of non-contrast magnetic resonance (MR) angiography in identifying crossing renal vessels in children younger than 4 years old with unilateral hydronephrosis.
Materials and methods
A retrospective review of preoperative MR urography of children with unilateral hydronephrosis was conducted by two independent readers. The presence or absence of crossing renal vessels was identified and compared with surgical findings.
Twenty-nine patients were included. The disagreement between MR angiography with and without contrast enhancement in detecting a crossing renal vessel was 8%. The disagreement between non-contrast-enhanced MR and surgical findings was 17%. The disagreement between contrast-enhanced MR angiography and surgical findings was 25%. The balanced triggered angiography without contrast enhancement had a sensitivity of 70% (95% confidence interval [CI]: 35-93%) and a specificity of 93% (95% CI: 66-100%). Contrast-enhanced MR angiography had a sensitivity of 56% (95% CI: 21-86%) and a specificity of 91%. (95% CI: 59-100%).
MR without contrast enhancement may be a reliable, valid and safe alternative to contrast-enhanced MR angiography for identifying crossing renal vessels.
KeywordsChildren Crossing renal vessel Hydronephrosis Magnetic resonance angiography Non-enhanced magnetic resonance imaging
Compliance with ethical standards
Conflicts of interest
- 5.Pavicevic PK, Saranovic DZ, Mandic MJ et al (2015) Efficacy of magnetic resonance urography in detecting crossing vessels in children with ureteropelvic junction obstruction. Ann Ital Chir 86:443–449Google Scholar
- 9.Mitterberger M, Pinggera GM, Neururer R et al (2008) Comparison of contrast-enhanced color Doppler imaging (CDI), computed tomography (CT) and magnetic resonance imaging (MRI) for the detection of crossing vessels in patients with ureteropelvic junction obstruction. Eur Urol 53:1254–1260CrossRefGoogle Scholar
- 11.Park SY, Kim CK, Kim E, Park BK (2015) Noncontrast-enhanced magnetic resonance renal angiography using a repetitive artery and venous labelling technique at 3 T: comparison with contrast-enhanced magnetic resonance angiography in subjects with normal renal function. Eur Radiol 25:533–540CrossRefGoogle Scholar
- 13.Brucher N, Vial J, Baunin C et al (2016) Non-contrast-enhanced MR angiography using time-spin labelling inversion pulse technique for detecting crossing renal vessels in children with symptomatic ureteropelvic junction obstruction: comparison with surgical findings. Eur Radiol 26:2697–2704CrossRefGoogle Scholar
- 16.Radmayr C, Bogaert G, Dogan HS et al. (2018) EAU Guidelines. Edn. presented at the EAU Annual Congress Copenhagen. ISBN 978-94-92671-01-1Google Scholar
- 26.Napolitano M, Damasio MB, Grumieri G (2012) Ruolo dell’uro-risonanza magnetica in urologia pediatrica: stato dell’arte. (Role of magnetic resonance urography in pediatric urology: state of the art). Prospettive in pediatria (rivista della Società Italiana di Pediatria) 42:163-169Google Scholar
- 34.Hu HH, Pokorney A, Towbin RB, Miller JH (2016) Increased signal intensities in the dentate nucleus and globus pallidus on unenhanced T1-weighted images: evidence in children undergoing multiple gadolinium MRI exams. Pediatr Radiol 46:1590–1598Google Scholar
- 36.Rossi Espagnet MC, Bernardi B, Pasquini L et al (2017) Signal intensity at unenhanced T1-weighted magnetic resonance in the globus pallidus and dentate nucleus after serial administrations of a macrocyclic gadolinium-based contrast agent in children. Pediatr Radiol 47:1345–1352CrossRefGoogle Scholar